How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $794.33 Median $4,570.88 Typical High $8,912.51 | Facility | None | $794.33 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $912.01 | Professional | None | $676.08 | $794.33 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $794.33 | Facility | None | $758.58 | $776.25 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,230.27 | Professional | None | $758.58 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $416.87 Typical High $575.44 | Professional | None | $54.95 | $416.87 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,122.02 | Professional | None | $831.76 | $977.24 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $977.24 Typical High $1,348.96 | Professional | None | $489.78 | $977.24 | $1,348.96 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,380.38 | Professional | None | $616.60 | $776.25 | $1,380.38 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $4,570.88 Typical High $6,606.93 | Facility | 50 · Both sides | $3,630.78 | $4,570.88 | $6,606.93 |
Where Utah sits
The same service costs 5.9 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Utah· 51st of 51
$457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.